William Osler once said: “Medicine is a science of uncertainty and an art of probability.” He was clearly inspired by a quote from Philipus Aureolus Paracelsus: “Medicine is not merely a science but an art. The character of the physician may act more powerfully upon the patient than the drugs employed.” An anonymous reporter took this one step further and said: “Medicine is an art, not a science.”
Transplanting organs is an art unto itself, even if it does heavily rely on science. The doctor must be as skilled as a artist, with each cut the surgeon makes as carefully planned as the brushes and strokes of a master painter. Xenotransplantation takes this art form to a new level.
Xenotransplantation involves transplanting one animal’s organ into another animal’s body. This is even possible for humans, a prospect that has stirred up much controversy over the years ever since 1984 when an infant received a heart transplant from a baboon, prompting a speculative article from The New York Times debating the use of xenotransplantaion. (Altman). While the baby in that case died a few days after the surgery, the idea of xenotransplantation has held a large amount of appeal to scientists and doctors alike.
According to a recent article by Amy Dockser Marcus in The Wall Street Journal, “there are more than 120,000 people in the U.S. waiting for an organ transplant,” with not nearly enough donors and useable organs to save each person (Marcus). While new developments have opened up in terms of 3-D printing and how it could possibly create useable organs for transplants, there is another option: xenotransplantation. Scientists have found that pigs are a likely source for these transplants. Marcus relates: “Pigs are a particularly promising source of organs. They produce big litters. Organs such as the kidney and liver are similar in size to those of humans” (Marcus).
In fact, the xenotransplantation is not a new process. The Guardian’s Vanessa Heggie wrote about how it first began in the 19th century and that an Irish surgeon, known simply as Doctor Bigger, while being held captive by the Bedouin, discovered how to successfully transplant the cornea of a wild deer into a blind gazelle. This idea was later applied to human transplants. She also revealed that in 1838, “Dr. Richard Kissam of New York transplanted the cornea of a 6-month old pig into a young man, who temporarily regained his sight” (Heggie). Then, “by 1885 five attempts had been made to transplant a whole eye from an animal into a human face. Four of those attempts used dog eyes, but the only initially successful one, by Dr HW Bradford of Boston, used a rabbit’s eye” (Heggie). In fact, Scientists and doctors have been transplanting animal blood into humans since the 17th century (Heggie).
While using a pig’s organs for xenotransplantation should work in theory, xenotransplantations are not always successful, especially not for long periods of time. The human immune system will attack any alien substances it finds, including that of the transplanted organ via a pig donor. There is also the issue of the transplant causing infections and undetected viruses moved from the pig to a human during the transplant.
To rectify this, scientists have since had to re-write some of the pig’s genetic code before the transplantation so that the human body will accept the organ. However, in the past it has taken incredibly long periods of time just to change one aspect of the pig’s genetic code. Recently though a group of scientists from Harvard University have created a new gene-editing system, Crispr-Cas9, which can change multiple aspects at once, working faster and more efficiently than ever before. This makes xenotransplantation all the more likely in the foreseeable future.
This takes us back to the aforementioned quotes comparing medicine to art and science, with one anonymous reporter going as far as to say that medicine is an art form, not a scientific one. The reasoning for this can be surmised from the fact that every patient and surgeon, physician, and doctor are different. Since no two are fully alike, you cannot completely replicate each transplant and surgery beat for beat, the way a scientific method should let you. Since the circumstances are different each time, the doctors involved must adapt to each new case with the same light-on-their feet attitude an artist has when using a new canvas or painting a new subject. Since we have determined that each case is different and cannot completely rely on science, but also the skill of the doctor, let’s think about how transplants, like medicine, is another art form. When we hear the word “art” we tend to think of paintings and sculptures. Are not physicians and surgeons similar to sculptures in some ways? They are not sculptures of marble or clay, but of real human flesh and blood. Perhaps that makes their “art” all the more masterful.
Still, we cannot ignore the importance of science when it comes to transplants, medicines, and anything else a doctor, physician, or surgeon would come across. Science is the whole reason transplants exist and can work. In conclusion, I believe that transplants, especially xenotransplants, are started by science, but completed through art. It all depends on the hands and strokes of the artist.
Altman, Lawrence. “Baby Fae, Who Received a Heart From Baboon, Dies After 20 Days.” The New York Times. 16, Nov 1984.
Heggie, Vanessa. “Human-pig chimeras and the history of transplanting from animals.” The Guardian. 7 June 2016.
Marcus, Amy Dockser. “Genetically Modified Pigs Could Ease Organ Shortage.” The Wall Street Journal. 1, Dec 2016.